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At least 541 records · Page 30Linked to original sources
PubMed1980

Chondral and osteochondral fractures after luxation of the patella and their treatment.

The traumatic luxation of the patella is the most frequent cause of osteochondral or chondral fragments in the knee joint. A precise case history most often provides the necessary reference concerning the occurrence of a luxation. The hemarthrosis and the painful reduction of the mobility after a closed spontaneous reposition hint towards the possibility of a chondral or osteochondral fracture requiring an emergency arthrotomy. If large chondral or osteochondral fragments are found intraoperatively, then a refixation of these fragments should be attempted. The following methods can be used: --a fixation with ASIF-mini screws --a fixation with Smillie pins --a fixation with cortical nails or --the removal. We will report about these methods being used at our clinic and will discuss the results. Many differing surgical methods are available for a causative treatment of the patella luxation. The application of the necessary method is dependent upon the age of the patient as well as on the pathological-anatomical circumstances. The differing methods will be described. The successful results of a refixation using a fibrin glue cannot be judged finally.

Fracture Fixation, Internal↗
PubMed1975

[Primary osteoma of the patella: a case report (author's transl)].

1. The literature concerning tumours of the patella is briefly reviewed. 2. A case of primary osteoma of the patella is reported. 3. Though a malignant tumour was excluded by roentgenology, age of the patient and localisation, a firm diagnosis could not be made before excision and histological examination of the enucleated tumour. 4. Some considerations concerning the origin of osteomas from the pathological point of view have been made.

Bone Neoplasms↗
PubMed1988

The effect of lateral retinacular release in idiopathic chondromalacia patellae.

The results of lateral retinacular release were evaluated in 28 patients with idiopathic chondromalacia patellae. Follow-up was performed 3-5 years after the operation. At follow-up 13 patients were improved, while the symptoms were equal or intensified in 15 patients. However, compared with the situation before the operation, the levels of activity were increased in only two patients, while the levels of activity were unchanged or reduced in the remaining 26 patients. From this study it is concluded that the results of lateral retinacular release for idiopathic chondromalacia patellae are poor with regard to relief of symptoms, and especially with regard to improvement in ability to perform physical activities.

Adolescent↗
PubMed1993

Ossification in the patellar tendon and patella alta following sports injuries in children. Complications of sleeve fractures after conservative treatment.

Two patients with sleeve fractures of the patella and tibial tuberosity respectively are described. Our two cases demonstrate that the diagnosis can be difficult; patella alta and ossification in the patellar tendon are complications of conservative treatment. Early diagnosis and operative reduction and fixation are mandatory.

Adolescent↗
PubMed1984

A modified Hauser procedure for recurrent dislocation of the patella. A long-term follow-up study with special reference to osteoarthritis.

A modified Hauser operation was used for the treatment of recurrent dislocation of the patella. Thirty-seven patients (40 knees) were traced for the purpose of long-term follow-up with regard to subjective and objective results and the degree of osteoarthritis in the patellofemoral joint. The mean follow-up time was 18 years. Only 12% of the patients had objectively satisfactory results, but 48% were satisfied with their operation. There was no correlation between the opinion of the patients and the objective findings. Dislocation recurred in 20% of the knees. More than two-thirds of the patients had some degree of osteoarthritis, and a poor result was always combined with osteoarthritis. The incidence of osteoarthritis increased with the time of follow-up and the age of the patient, but it was also found in younger patients. It seems that distal realignment of the patella enhances the development of osteoarthritis.

Adolescent↗
PubMed1996

Chondropathia patellae and knee muscle control. An electromyographic study.

The activity of knee-related muscles was registered via exercising on a bicycle ergometer by 17 patients with clinically diagnosed chondropathia patellae. M. quadriceps activity was shorter and the hamstring activity longer in the chondropathy group compared with a matched healthy control group. The changes in m. quadriceps occurred to an almost equal extent in lateral and medial sections. In five patients with unilateral complaints, the electromyographic changes were nevertheless noted on both sides. The study shows that chondropathia patellae involves a change in muscle control affecting not only the knee extensors but also the hamstrings. Through the changed innervation pattern the coactivation phase, i.e. the phase of simultaneous activation of knee flexors and extensors at the end of the extension phase, takes place at a higher angle of flexion. Physiotherapy should involve all knee-related muscles and should include not only isometric but also dynamic exercises.

Adult↗
PubMed1995

Bone-scintigraphy in painful bipartite patella.

We report the scintigraphic-appearances of painful bipartite patella in 25-year-old man a 2 1/2 years history of unexplained patellar pain. Painful bipartite patella is a rare cause of chronic post-traumatic patellar pain. Bone scintigraphy, by demonstrating increased uptake by the painful accessory bipartite fragment, appears to be an imaging method of choice in the diagnosis of this condition.

Adult↗
PubMed1977

[Injury of the patella (author's transl)].

Fractures of the patella account for about 1% of all fractures. They result from the impact of direct or indirect forces. Various fracture types are distinguished. Treatment of simple transverse or oblique fractures consists of anatomic reduction, with special attention to perfect reconstruction of the retro-patellar gliding surface. Tension banding is used for fixation to achieve functional stability. Comminuted fractures in the pole region may require partial resection along with careful reconstruction of the extensor mechanism. In cases of complete communition of the patella, early patellectomy is recommended and gives better results than late patellectomy.

Acute Disease↗
PubMed1995

Results in the treatment of recurrent dislocation of the patella after 30 years' follow-up.

The authors compare the clinical and radiographic outcome in patients with comparable bilateral recurrent patellar dislocation treated surgically on only one side, to clarify the appropriateness of the surgical indication. Sixteen patients were evaluated at an average follow-up of 30 years (20-45); all had been treated by the Roux technique. The results on both the operated and the unoperated knee were evaluated; the Crosby and Insall schedule was used for the clinical evaluation. Anteroposterior, lateral, and Merchant's view X-rays were examined for osteoarthritis and to measure the height of the patella. The congruence angle and the distance between anterior tibial tuberosity and trochlear groove (ATT-TG) were measured by computed tomography. The results in the operated knees were: 3 excellent, 9 good, 1 fair, and 3 worse; results in the nonoperated knees were 6 excellent, 8 good, 1 fair, and 1 worse. In the operated knees arthritis was grossly marked in 8, marked in 3, moderate in 1, and light in 4; in the nonoperated ones it was grossly marked in 8, moderate in 3, and light in 5. The congruence angle was normal in 10, medially displaced in 3, and laterally displaced in 3 cases on the operated side; on the nonoperated side it was normal in 7 cases and lateralized in the remaining 9. The ATT-TG in the operated knees was negative in 9 cases, normal in 1, and positive in 6; on the non-operated side it was positive or normal. In 7 operated cases a low patella was documented. The Roux technique yields positive results in the correction of recurrent dislocation. No clinical or radiographic differences were found between surgically and conservatively treated knees. The clinical results are generally not comparable with the radiographic features or with severity of degenerative modifications presented at long-term follow-up. The absence of a difference is due basically to the complete lack of adaptation of the surgical procedure to the variable pathogenesis of this disorder.

Adolescent↗
PubMed1995

Clavicular horn: another bony projection in nail-patella syndrome.

Nail-patella syndrome is an uncommon inherited disorder characterized by nail dysplasia, iliac horns, and knee and elbow abnormalities. We report a patient with nail-patella syndrome in whom calvicular horn, shoulder girdle dysplasias, and pelvic abnormalities were demonstrated, along with the classical tetrad.

Acromion↗
PubMed1992

Nail-patella syndrome associated with mixed crystal deposition arthropathy.

This report describes a case of nail-patella syndrome in a woman with a strong family history who presented with effusions in her shoulder and knees. Microscopic examination of the shoulder fluid suggested the presence of calcium pyrophosphate dihydrate (CPPD) crystals, and examination of the knee fluid suggested both hydroxyapatite (HAP) and CPPD crystals. To our knowledge, the coexistence of these two conditions has not been reported in the past. Moreover, it brings up a new element regarding the inflammatory origin of the nail-patella syndrome.

Arthritis↗
PubMed1983

Fractures of the patella treated by operation.

A retrospective analysis of 93 operatively treated fractures of the patella is presented. Tension band fixation was used in 14, circumferential wire in 15 and screw fixation in 19 patients. Partial patellectomy was performed in 35 cases and total patellectomy in 10 cases. The result was considered excellent in 27% of the patients, good in 49%, fair in 16% and poor in 8%. Patients under 30 years of age had better results than the older ones (p less than 0.01). Tension band fixation gave results superior to screw fixation (p less than 0.05) and partial patellectomy superior to total patellectomy (p less than 0.02). The length of the immobilization time in plaster showed no statistical significance. As a result of this investigation tension band fixation and partial patellectomy seem to be the methods of choice in the management of those fractures of the patella which need operative treatment.

Adolescent↗
PubMed1991

[Therapeutic measures in subluxation and dislocation of the patella].

The pathology of patella dislocation is divided into different groups: primary, secondary, recurrent dislocation and patella subluxation. In the diagnosis, in addition to clinical and X-ray investigations a certain computerized tomography extended on the SEG examination. A new examination of the EG tomographs had increased the diagnostic facilities. Our therapeutical program is based on physical therapy. After failure of physiotherapy to achieve satisfactory results the operation technique according to Slocum and Larson is performed.

Adolescent↗
PubMed2004

Sleeve fracture of the superior pole of patella: a case report.

The growing patella is more vulnerable to osteochondral or avulsion fractures. Avulsion or sleeve fractures can occur at the superior or lower pole. Superior pole fractures are very rare. A case of superior pole sleeve facture of the patella is presented and the treatment described.

Adolescent↗
PubMed2005

Should we resurface the patella in total knee replacement? Experience with the Nex Gen prothesis.

Patellar resurfacing is a controversial issue in primary total knee replacement. So, we took advantage of a large study to try and answer this question. An open prospective multicentric study was conducted about the outcome of the Nex Gen Total Knee prosthesis with clinical and radiological follow-up at regular intervals (1, 2 and 5 years). The data were centrally collected and analyzed by independent observers. A total of whole 5,915 cases were included (487 in the French group); incidences of patello-femoral pain were observed in both French and international groups and compared between cases with or without resurfaced patellae. Only osteoarthritic cases were selected for this particular study. Statistical analysis was performed using a Pearson's Chi-square test with a 95% confidence interval. The frequency of preoperative pain was significantly higher in the French group; 85.1% versus 66.6% (p<0.05). No patello-femoral pain appeared in preoperatively painless patients in the French group. The frequency of lateral patellar release was similar in both groups. 35.7% of the patellae were resurfaced in the international group versus 98.8% in the French one. At 2 years, patello-femoral pain was observed in 6.3% of cases in the former group versus 0.7% in the latter one. The risk of having patello-femoral pain was 9.45 times higher in the international group. When considering resurfaced cases in both groups the risk of having anterior knee pain was not significantly different (p=0.35). In the French group, one case out of nine (11.1%) with patello-femoral pain had not been resurfaced, while 129 cases out of 151 (85.4%) had not had a resurfacing in the international group. This emphasizes the effect of patellar implant on pain. Although patello-femoral pain is multifactorial, this analysis tool is powerful in getting rid of the "center effect " (cf Swedish register). Even if a longer follow-up for confirmation is needed, our data favor patellar resurfacing with this type of implant in spite of the fact that the trochlear design was considered as anatomical.

Aged↗
PubMed2005

Clinical and radiological outcome of medial patellofemoral ligament reconstruction with a semitendinosus autograft for patella instability.

BACKGROUND: Recurrent patellar instability is a common problem after dislocation. The medial patellofemoral ligament (MPFL) contributes 40-80% of the total medial restraining forces. This study assessed the clinical and radiological outcome after a follow-up of 4 years after linear MPFL reconstruction using an ipsilateral Semitendinosus tendon autograft. STUDY DESIGN AND METHODS: 15 knees in 12 patients were examined with a mean of 47 months after linear reconstruction of the MPFL at a mean age of 30 years. 3 knees underwent previous surgery. 3 patients had mild trochlear dysplasia grade I or II, according to the classification of Dejour. If preoperative tibial tuberosity-trochlear groove distance (TTTG) was more than 15 mm, patients underwent additional medialisation of the tibial tuberosity (n=8) creating a similar postoperative situation for all patients. All patients were available for a postoperative evaluation, which consisted of a subjective questionnaire, the Kujala score, and the recording of potential patellar redislocation and apprehension. Patellar height and tilt was measured on plain radiographs. Postoperative CT scans were performed in patients with an additional tibial tuberosity-transfer. RESULTS: Postoperatively, one patient reported on recurrent bilateral redislocation. Physical examination however revealed no findings. Three knees presented with persistent patellar apprehension. Thirteen knees had improved subjectively after surgery. The mean Kujala score improved significantly from 55.0 to 85.7 points. The patellar tilt decreased significantly from 11.3 degrees to 9.2 degrees. Four knees had patella alta preoperatively, but only two at the latest follow-up visit. Previous surgery or additional trochlear dysplasia had no influence on the clinical outcome. CONCLUSION: MPFL reconstruction improves clinical symptoms, reduces the patellar tilt substantially, and may correct patella alta. Additional mild trochlear dysplasia did not compromise the outcome; however, this fact needs further attention in a larger study group.

Adult↗